Skip to main content
SpringerLink
Log in

Asthma in the Elderly

  • Reference work entry
  • First Online:
Geriatric Diseases

  • 1594 Accesses

Abstract

In the elderly, asthma is superimposed on changes related to ageing, immune function and other diseases common in older age. The aetiology of asthma in the elderly is multifactorial and complex. One-third of the older patients experience breathlessness which is a non-specific symptom in the elderly, and the differential diagnosis includes, besides asthma, COPD and non-respiratory conditions such as cardiac failure, deconditioning, obesity and infection, amongst others. Cough is a prominent symptom in the elderly asthmatics and may be the only symptom. The difficulty of making a diagnosis in the elderly is due to a number of factors. Spirometry has been used as a ‘gold standard’ in the diagnosis of asthma but there a number of limitations especially in the older patient. Asthma is common in the elderly and often is misdiagnosed, underdiagnosed and undertreated resulting in significant negative consequences for the patient’s health.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 379.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Melani AS. Management of asthma in the elderly patient. Dovepress J. 2013; 2013(8):913–922.

    Google Scholar 

  2. Hanania NA, King MJ, Braman SS, Saltoun C, Wise RA, Enright P, et al. Asthma in the elderly. Current understanding and future research needs-a report of a National Institute in Aging (NIA) workshop. J Allergy Clin Immunol 2011;128(3suppl): S4–24.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ariano R, Pauzani RC, Angeri G. Late onset asthma clinical and immunological data: importance of allergy. J Invest Allergol Clin Immunol 1998;84:35–41.

    Google Scholar 

  4. Litonjua AA, Sparrow D, Weiss ST, O’Connor GT, Long AA, Ohman JL, et al Sensitization to cat allergen in the elderly is associated with asthmas in older men and predicts new-onset airways hyperresponsiveness. Am J Respir Crit Care Med. 1997.;156:22–27.

    Article  Google Scholar 

  5. Rogers L, Cassino C, Berger KI, Goldring RM, Robert G. Asthma in the elderly: cockroach sensitization and severe of airway obstruction in elderly non-smokers. Chest 2002;122(5): 1580–1586.

    Article  PubMed  Google Scholar 

  6. Krcmarik JP, Kain KP. Diagnosis and treatment of asthma in elderly patients. Website: http://www.yourlunglealth.org/healthy_living/aah/07.07/articles/elderly/.

  7. Barua P, O’Mahoney MS. Overcoming gaps in the management of asthma in older patients: new insights. Drugs Aging. 2005;22:1029–59.

    Article  CAS  PubMed  Google Scholar 

  8. Jones SC, Iverson D, Burns P, Evers U, Caputi P, Morgan S. Asthma and ageing: an end user’s perspective – the perception and problems with the management of asthma in the elderly. Clin Exp Allergy. 2011;41(4):471–481.

    Article  CAS  PubMed  Google Scholar 

  9. Braman SS, Hanaia NA. Asthma in older adults. Clin Chest Med. 2007;28(4):685–702.

    Article  PubMed  Google Scholar 

  10. Braman SS, Kaemmerlen JT, Davis SM. Asthma in the elderly: a comparison between patients with recently acquired and long standing disease. Amer Rev Respir Dis. 1991;43:336–40.

    Article  Google Scholar 

  11. Abramson MJ, Perret JL, Dharmage SC, McDonald VM, McDonald CF. Distinguishing adult-onset asthma from COPD: a review and a new approach. Int J Chron Obstruct Pulmon Dis. 2014;9:945–62.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Miranda C, Busacker A, Balzar S, Trudeau J, Wenzel SE. Distinguishing severe asthma types: role of age at onset and eosinophilic inflammation. J Allergy Clin Immunol. 2004;113(1):101–8.

    Article  PubMed  Google Scholar 

  13. de Nijs SB, Venekamp LN, Bel EH. Adult-onset asthma: is it really different? Eur Respir Rev. 2013;22(127):44–52.

    Article  PubMed  Google Scholar 

  14. Tzortzaki EG, Proklou A, Siafakas NM. Asthma in the elderly: Can we distinguish it from COPD? J Allergy. 2011;Article ID 843543,7 pages https://doi.org/10.1155/2011/843543.

  15. De Martinis M, Franceschi D, Monti D, Ginaldi L. Inflamm-ageing and lifelong antigenic load as major determinants of ageing rate and longevity. FEBS Letters. 2005.;579(10):2035–2039.

    Article  PubMed  Google Scholar 

  16. Kitch BT, Levy DL, Fanta CH. Late onset asthma: epidemiology, diagnosis and treatment. Drugs Aging. 2000;17:385–397.

    Article  CAS  PubMed  Google Scholar 

  17. Bella V, Battaglia S, Catalano F, Scichilone N, Incalzi RA, Imperiale C, et al Aging and disability affect misdiagnosis of COPD in elderly asthmatics: the SARA study. Chest. 2003:123:1066–72

    Article  Google Scholar 

  18. Yates MW. How is the diagnosis of asthma in older people established in clinical practice. MJA. 2005;183:S44-S46.

    PubMed  Google Scholar 

  19. Juck C, Lye M. Asthma in the elderly patient. Gerontology. 1996;42:61–68.

    Article  Google Scholar 

  20. de Bisschop C, Marty ML, Tessier JF, Barberger-Gateau P, Dartigues JF, Guenard H Expiratory flow limitation and obstruction in the elderly. Eur Respir J. 2005;26(4) 594–601.

    Article  PubMed  Google Scholar 

  21. Dow L. Epidemiology and therapy of airway limitation in the elderly. Drugs Aging 1992;2:546–559.

    Article  CAS  PubMed  Google Scholar 

  22. Enright PL, Kronnal RA, Higgins M, Schenker M,Haponik EF. Spirometry reference values for women and men 65 to 85 years of age. Cardiovascular Health Study. Am Rev Respir Dis. 1993;147:125–133.

    Article  CAS  PubMed  Google Scholar 

  23. Parameswaran K. Asthma in the elderly: under recognised, underdiagnosed and undertreated: a community survey. Respir Med. 1998;92:573–577.

    Article  CAS  PubMed  Google Scholar 

  24. Lotvall J. Pharmacological similarities and differences between beta-2 agonists. Respir Med. 2001;95:S7-S11.

    Article  PubMed  Google Scholar 

  25. Montuschi P, Macagno F, Valente S, Fuso L. Inhaled muscarine acetylcholine receptor antagonists for treatment of COPD. Curr Med Chem. 2013;20(12):1464–76.

    Article  CAS  PubMed  Google Scholar 

  26. Currie GP, Lee DK,Lipworth BJ. Long-acting beta-2 agonists in asthma: not so smart. Drug Saf 2006;29(8):647–56.

    Article  CAS  PubMed  Google Scholar 

  27. NPS NEWS. Inhaled corticosteroids and long-acting beta 2 agonists in asthma and COPD. National Prescribing Service Newsletter. No: 58, 2008.

    Google Scholar 

  28. Chung KF,Caramori G, Adcock IM. Inhaled corticosteroids as combination therapy with beta-adrenergic agonists in airways disease: present and future. Eur J Clin Pharmacol. 2009;65(9):853–71.

    Article  CAS  PubMed  Google Scholar 

  29. Hancox RJ, Taylor DR. Long-acting beta-agonist treatment in patients with persistent asthma already receiving inhaled steroids. Bio Drugs. 2001 15(1):11–24.

    CAS  Google Scholar 

  30. Expert Panel Report3 (EPR-3). Guidelines for the diagnosis and management of asthma-summary report 2007. J Allergy Clin Immunol. 2007;120(5suppl):S94–138.

    Google Scholar 

  31. Miller-Larsson A, Selroos O. Advances in asthma and COPD treatment: combination therapy with inhaled corticosteroids and long acting beta 2-agonists. Curr Pharm Des. 2006;12(25):3261–79.

    Article  CAS  PubMed  Google Scholar 

  32. Olin JT, Wechsler ME. Asthma: pathogenesis and novel drug treatment. BMJ. 2014;349:g5517.

    Article  PubMed  Google Scholar 

  33. Slavin RG. The elderly asthmatic patient. Allergy and Asthma Proceedings. 2004;25(6):371–373.

    PubMed  Google Scholar 

  34. Urso DL. Asthma in the elderly. Curr Gerontol Geriatr Res 2009:2009:858415. https://doi.org/10.1155/2009/858415.

  35. Enright PL. The diagnosis and management of asthma is much tougher in older patients. Curr Opin Allergy Clin Immunol. 2002;2(3):175–181.

    Article  PubMed  Google Scholar 

  36. Kitch BT, Levy, Fanta CH. Late onset asthma. Epidemiology diagnosis and treatment. Drugs Aging 2000;17(5):385–397.

    Article  CAS  PubMed  Google Scholar 

  37. de Nijs SB, Venekamp LN, Bel EH. Adult onset asthma: is it really different? Eur Respir Rev. 2013;22:44–52.

    Article  PubMed  Google Scholar 

  38. Braman SS. Growing old with asthma: What are the changes and challenges? Expet Rev Respir Med. 2010;4(2):239–48.

    Article  Google Scholar 

  39. Smith AM, Villareal M, Bernstein DI, Swikett DJ. Asthma in the elderly: risk factors and impact on physical function. Ann Allergy Asthma Immunnol. 2012;10(5):305–10.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The University of Sydney, Westmead Clinical School, Westmead, NSW, Australia

    Nages Nagaratnam & Kujan Nagaratnam

  2. Rehabilitation and Aged Care Service, Blacktown-Mt Druitt Hospital, Mount Druitt, NSW, Australia

    Gary Cheuk

Authors
  1. Nages Nagaratnam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kujan Nagaratnam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gary Cheuk
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Nagaratnam, N., Nagaratnam, K., Cheuk, G. (2018). Asthma in the Elderly. In: Geriatric Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-33434-9_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-33434-9_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33433-2

  • Online ISBN: 978-3-319-33434-9

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation